Advances in therapeutics and vaccines for Marburg virus disease: challenges and future directions.
TL;DR
The human monoclonal antibody MR191N provides complete post-exposure protection in non-human primates and necessitates adaptive trial designs, expanded diagnostic models, and synergistic combination therapies to address MVD.
Abstract
INTRODUCTION Marburg virus disease (MVD) is a highly lethal filovirus infection with case fatality rates of up to 88%. Although no virus-specific interventions have yet been approved, recent laboratory breakthroughs have markedly accelerated translational progress in vaccine and therapeutic development. AREAS COVERED A hybrid methodological design was employed, combining macro-level bibliometric analysis with a targeted qualitative narrative review. As per the findings, the human monoclonal antibody MR191N provides complete post-exposure protection in non-human primates. Advanced RNA-targeted siRNAs, antisense oligonucleotides, and small-molecule nucleoside analogues (e.g. galidesivir) demonstrate robust preclinical efficacy in suppressing viral replication. Prophylactic platforms - including adenovirus-vectored (ChAd3-MARV), rVSV-MARV, and mRNA-based vaccines - are progressing through early-phase clinical and preclinical evaluation. Bibliometric analysis, however, reveals pronounced geographic disparities: high-income nations dominate scientific output (United States: 31.7%), while endemic African countries remain severely underrepresented in global collaboration networks. EXPERT OPINION Addressing MVD requires a coordinated transition from experimental research to licensed, field-ready interventions. This necessitates adaptive trial designs, expanded diagnostic models, and synergistic combination therapies. Ultimately, correcting global research inequities and embedding robust, cross-border One Health surveillance infrastructure are essential to transforming scientific advances into equitable, rapid-response solutions for endemic regions.